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RULE §405.103Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.

  (1) Chemical or gaseous agents--Those substances which may be capable of inducing a seizure and including, but not limited to, pentylenetetrazol (Metrazol) and flurothyl (Indoklon).

  (2) Chief executive officer--The superintendent or director of a state hospital, state school, or state center; the executive director of a community mental health and mental retardation center; or the person responsible for management and operation of a hospital or other health care facility or entity providing ECT.

  (3) Commissioner--The commissioner of the Texas Department of Mental Health and Mental Retardation.

  (4) Community mental health and mental retardation center--A community mental health and/or mental retardation center established by the Texas Health and Safety Code, Chapter 534.

  (5) Department--The Texas Department of Mental Health and Mental Retardation.

  (6) ECT--Electroconvulsive therapy.

  (7) Electroconvulsive therapy (ECT)--A treatment in which controlled, medically applied electrical current results in a therapeutic seizure, usually attenuated by anesthesia and muscle relaxants.

  (8) Fully qualified psychiatrist--A physician, licensed to practice medicine in Texas, who has completed approved residency training in psychiatry.

  (9) Informed consent--The knowing consent of a patient or the guardian of the person of the patient in keeping with the provisions of §405.108 of this title (relating to Informed Consent to ECT), so situated as to be able to exercise free power of choice without undue inducement or any element of force, fraud, deceit, duress, or other form of constraint or coercion. If consent is given by the guardian of the person of a patient who has been adjudicated incompetent to manage his or her own personal affairs, then the decision must be based on knowledge of what the patient would desire, if known.

  (10) Insulin coma treatment--The production of a coma for therapeutic purposes through the administration of insulin.

  (11) Maintenance therapy--Treatment with electroconvulsive therapy on an individually determined intermittent schedule for purposes of preventing relapse.

  (12) Multiple-monitored ECT--The induction of more than one adequate seizure during one episode of anesthesia.

  (13) Nurse anesthetist--A nurse credentialed by the Board of Nurse Examiners as a nurse anesthetist.

  (14) Prefrontal sonic sound treatment--A treatment, not described or defined in biomedical literature, which is defined in California statutes governing ECT and other treatments as "The direct stimulation and/or destruction of brain cells or brain tissue by ultrasound for therapeutic purposes."

  (15) Psychosurgery--Surgical intervention to sever fibers connecting one part of the brain with another or to remove or to destroy brain tissue with the intent of modifying or altering severe disturbances of behavior, thought content, or mood. For purposes of this subchapter, the term does not include such surgery for the relief of intractable physical pain or the treatment of neurological disease or abnormality.

  (16) Regressive or depatterning ECT--The prolonged use of daily or more frequent treatments.

  (17) Reportable therapies--Electroconvulsive therapy, insulin coma treatment, "prefrontal sonic sound treatment," psychosurgery, multiple-monitored ECT, "regressive" or "depatterning" ECT, or any other convulsive or coma-producing therapy to treat mental illness.

  (18) Series of treatments--Usually six-15 treatments.

  (19) TXMHMR medical director--The department's medical director.

  (20) Treatment--The administration of electroconvulsive therapy, unilaterally or bilaterally, with anesthesia, under appropriate clinical conditions for monitoring, safety, and efficacy.

Source Note: The provisions of this §405.103 adopted to be effective January 1, 1992, 16 TexReg 7528; amended to be effective December 10, 1993, 18 TexReg 8790

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